What is a Personality Disorder?

There are a number of definitions of personality disorder. Most agree that personality disorders affect the way people think and feel about themselves and others. People with personality disorders tend to have ideas and feelings that negatively affect the way they relate to others, while also resulting in considerable negative feelings and ideas towards themselves.

While many of us experience these feelings from time to time, the features that define a personality disorder are the intensity and frequency of the negative thoughts and feelings the person experiences.

People with personality disorder have these experiences to a significantly higher degree than the general population. This can potentially cause serious and intense psychological pain, suffering and instability. Sometimes the distress associated with these feelings may cause the person to engage in self-harm or other harsh, risky and damaging activities, in an attempt to escape the negative intensity of their experiences.

There are six types of personality disorder, each with its own particular characteristics. The following information provides an overview of some of the more recognisable symptoms and behaviours for these personality disorders.

BPD is a term used to describe a certain set of difficult experiences (symptoms) that some people have. A BPD diagnosis is based on an assessment of these symptoms over time, and across a range of situations.

Experiences of BPD include:

Strong, overwhelming emotions and feelingPeople with BPD describe overwhelming, almost constant emotional pain. Strong emotions are easily triggered. Some people have learned to cope with this by repressing many of their emotions; however the need to dampen down emotions can result in feelings of numbness, unreality and boredom. Problems with anger are common, and those with BPD may feel angry a lot of the time. They may become violent or aggressive when angry.

RelationshipsPeople with BPD can experience strong and changeable feelings of love and hate, along with heightened sensitivity to signs of rejection or criticism. This may be accompanied by a tendency not to trust people, and difficulty coping with losses and separations. It’s common for problems with dependency to arise — either becoming very dependent on others, or trying to avoid dependency or closeness.

Impulsive, often self-destructive behaviourThis often involves deliberate self-harm or suicide attempts in response to feeling emotionally overwhelmed. Self-harm can bring some momentary or short-term relief from suffering; however it results in longer-term negative consequences. People with BPD may attempt to cope with intense feelings through drug or alcohol abuse, binge eating, or problem gambling.

Fragile sense of selfThis refers to problems experiencing or identifying a consistent sense of self, or personal identity. Maintaining a clear and stable sense of one’s own feelings and thoughts can be difficult. During times of stress some people may withdraw, leaving them feeling vulnerable and alone. At times like this, feeling threatened or becoming paranoid is common. This usually passes when the level of stress reduces.

You can also refer to the formal diagnostic criteria for BPD on page 44 of the NHMRC Clinical Practice Guideline for the Management of Borderline Personality Disorder. The Royal Australian and New Zealand College of Psychiatrists (RANZCP) has also published a helpful guide for consumers and clinicians about BPD.

People with obsessive-compulsive personality disorder (which is different to the anxiety disorder, obsessive-compulsive disorder), exhibit a rigid adherence to rules and regulations. They also experience an overwhelming need for order, show unwillingness to yield, or give responsibilities to others, and may have inflexible views regarding morality, ethics and values.

People with avoidant personality disorder have a lifelong, deeply ingrained pattern of extreme shyness, extreme sensitivity to criticism or rejection, avoidance of work activities that require interpersonal contact, and deep feelings of inadequacy.

People with schizotypal personality disorder are often described as odd or eccentric in their dress, thinking or beliefs. They have flat emotions or inappropriate emotional responses, experience social anxiety, and usually have few, if any, close relationships. They may have odd perceptual experiences and believe that casual incidents have hidden meanings meant only for them. They may also misinterpret others’ motivations and behaviours and develop significant distrust of others.

People with antisocial personality disorder have trouble distinguishing between right and wrong, and don’t take into account the rights and feelings of others. They may exhibit behaviours that are impulsive, antagonistic, aggressive, or violent. They may also disregard their own safety, as well as the safety of others. They may be unable to experience guilt or remorse for their behaviours.

People with narcissistic personality disorder may behave as though they are special or more important than others. They often have a deep need for admiration, and experience difficulty recognising the needs and feelings of others. They may exaggerate their achievements or talents, and have fantasies about power, success and attractiveness. This apparent ultra-confidence may mask a fragile self-esteem that is prone to envy and vulnerable to criticism.